The reflectance confocal microscopy — lights and shadows: A case series

Reflectance confocal microscopy (RCM) is a non-invasive in vivo diagnostic method that increases the sensitivity and specificity of melanoma diagnosis when used complementarily with dermoscopy. There are benign and malignant melanocytic lesions in the so-called grey zone of non-invasive diagnostics, whose dermoscopic patterns overlap, and RCM examination shows only minor abnormalities. An increasing number of studies indicate the need to include many factors during the skin examination, some of which are unrelated to the diagnostic method used, such as the patient’s age, skin phototype, location and size of the skin lesion, personal/family history of melanoma/skin cancers, or the “ugly duckling” sign. In the example of three cases evaluated with dermoscopy, the iDScore 2021 algorithm and RCM, the authors illustrated the need for a complementary approach to diagnosing melanocytic lesions, despite patients’ differentiated risk of melanoma.